Leah Hazard has been a midwife for nearly 10 years, supporting thousands of families in labour suites, ante- and postnatal wards, triage departments and community clinics. She continues to work at a large maternity hospital in Scotland
5.50am – My alarm goes off and I creep downstairs, trying not to wake my husband, my daughter or the dog. Although I’m barely awake, I force myself to have breakfast before a shift: a bit of food will keep me going if the morning is hectic and my first break is delayed. I scroll through social media while eating; maternity services are often in the news for all the wrong reasons. It’s hard to keep showing up in a system that’s severely under-resourced and deeply flawed, but I brush my teeth, grab my bag and go.
7.30am – I’ve driven to the hospital, changed into my uniform, and my shift begins with a handover from the night staff to the day staff: a verbal run-down of all the patients in the department, their histories, their management plans and any overall issues. I usually work in maternity triage, which I often describe as “A&E for pregnant people”. We are the frontline of the maternity service: as well as being the first to assess women in labour, we also deal with every other acute issue that might arise in pregnancy and the postnatal period: reduced fetal movements, bleeding, abdominal pain, high blood pressure, excessive vomiting, mastitis and severe illness such as Covid or flu. I never know what my day will bring, which is exciting, but also sometimes quite terrifying.
10.30am – The shift has got off to a relatively gentle start: we’ve seen a few women whose waters have broken overnight, as well as some with bleeding and reduced movements. Sometimes, though, I’ve already caught a baby by breakfast; although most women make it to the labour ward (or have planned home births), some babies are in much more of a hurry and are born in our department, or in the car park. I’m lucky that today has been fairly calm so far. We’re fully staffed – a thing of wonder – and I’m sitting down to my first break now.
1pm – As predicted, the department has become much busier, and although my colleagues and I should be thinking about planning lunch breaks, it’s just not safe for any of us to leave the floor. We have two women in labour, one with a suspected haemorrhage, one whose baby hasn’t moved in three days, an unwell asylum seeker who needs medical review and complex social input, and a Covid patient with a dangerously high fever.
Another ward has asked for one of us to help with their drug round; I speak to the hospital coordinator to update her on our workload. Many days in maternity feel like one long game of robbing Peter to pay Paul: midwives are often moved to fill gaps in ward staff, but that always leaves somebody else short.
3pm – Finally, it’s safe to stop for lunch. Our tea room is a windowless box, so I often like to go for a walk and eat outside if weather permits. The fresh air feels amazing on my face as I slip my mask off and blink in the sunshine. I start walking and gulping down big bites of sandwich when I see the usual knot of anti-abortion protesters gathered outside the hospital perimeter. They’re there at least once a week, often holding signs with messages of damnation and glaring at women as they head inside.
My heart leaps with anger; many women attend our hospital for essential abortion care after learning that their pregnancy has a life-threatening complication. These women are in a state of deep grief, and they are treated with the utmost compassion and skill. In Scotland, legislation is under way to enforce buffer zones around premises like ours where terminations are carried out (similar laws look likely to pass soon in England and Wales), but the process is frustratingly slow. Resisting the urge to confront the protesters, I bolt down the last of my sandwich and head back to work.
5pm – This is the time when, as we say, “the bus comes in”: not an actual bus, but a very predictable rush of patients. Mothers have done the school run and GPs get in touch with the last of their day’s referrals. The waiting area is full and every bed is occupied. I can feel my blood pressure rising, but I just have to keep going. I try to be methodical, writing down tasks and ticking them off as I go – IV antibiotics to give, heartbeats to check, hands to hold – but these women deserve more care and more time. Time I just can’t give.
7.45pm – The final few hours of my shift pass in a blur until the night staff arrive. They cringe when they see the workload in the unit; I have to admit that I’m glad I’m not in their shoes, and I head for the door as soon as I’ve given my handover.
10pm – After a late dinner and an hour of trash TV – maybe Below Deck or First Dates – I fall into bed, semi-conscious before my head hits the pillow. I’ve barely said a word to my family since I came home; they know I’m not fit for conversation or rational thought after a 12-hour shift.
4am – I wake up in a sweat after dreaming about work all night: imaginary patients I’ve forgotten to treat, buzzers I should have answered, prescriptions I should have signed. Fortunately, I’m not working again today. I seldom do two day shifts in a row any more. Like many of my colleagues, working through the pandemic has taken a huge toll on my physical and mental health and I’ve already experienced episodes of severe stress and burnout, so now I try to space out my shifts when I can. I know I’m lucky to have that option. I roll over and fall back into a fitful sleep, but even in my dreams, midwifery never really leaves me. It’s part of me, for better or for worse.
Leah Hazard’s books include The Father’s Home Birth Handbook, the Sunday Times bestseller Hard Pushed: A Midwife’s Story. Womb: The Inside Story of Where We All Began is published by Virago on 2 March in hardback, £18.99